Individual
THEODORA J MARZOUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3317 ELM STREET, SUITE 202, OAKLAND, CA 94609
(510) 923-9790
(510) 923-9599
Mailing address
3317 ELM ST STE 202, OAKLAND, CA 94609-3053
(510) 923-9790
(510) 923-9599
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
020000416
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020000416
HOME HEALTH LICENSE
CA
Enumeration date
07/14/2017
Last updated
07/21/2022
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